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General NPI Number Information
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NPI Number | 1457978413
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Entity Type | Individual
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Provider Name | NADESSA COREA-LEVY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 1720 EL CAMINO REAL STE 165
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City | BURLINGAME
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State | CA
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Zip | 94010-3200
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Country | US
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Telephone | 650-692-0977
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Fax |
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Provider Business Mailing Address
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Address Line | 2 JUAN BAUTISTA CIR
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-2440
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Country | US
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Telephone | 415-858-4007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95015080
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95066473
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License Number State | CA
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